IRDAI Removes Age Limit for Health Insurance, Enhancing Coverage and Accessibility

The Insurance Regulatory and Development Authority of India (IRDAI) has taken a significant step towards enhancing healthcare accessibility and coverage by eliminating the age limit of 65 years for individuals purchasing health insurance policies. This move aims to foster a more inclusive healthcare ecosystem and provide comprehensive protection against unforeseen medical expenses.

Key Points:

1. Removal of Age Limit: Previously, individuals were restricted from purchasing new health insurance policies after the age of 65. However, the recent amendment, effective from April 1, allows individuals of any age to buy new health insurance policies.
2. Inclusive Product Offerings: IRDAI mandates insurers to offer health insurance products catering to all age groups. Insurers are encouraged to design specific products tailored for senior citizens, students, children, maternity, and other specified groups.
3. Coverage for Pre-Existing Conditions: Insurance companies are now required to provide coverage for individuals with pre-existing medical conditions, such as cancer, heart or kidney failure, and AIDS. Denial of coverage based on pre-existing conditions is prohibited.
4. Flexible Premium Payment: Insurers are permitted to offer premium payment options in instalments, enhancing convenience for policyholders.
5. AYUSH Treatment Coverage: There is no limit on coverage for treatments under Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homeopathy. Such treatments will receive coverage up to the sum insured without any cap.
6. Multiple Claims Filing: Policyholders with benefit-based policies can file multiple claims with various insurers, providing flexibility and choice.
7. Specialised Channel for Senior Citizens: The regulation establishes a specialised channel to handle complaints and claims of senior citizens, ensuring a tailored and responsive approach to their requirements.

The removal of age restrictions and the introduction of comprehensive coverage for pre-existing conditions signify a significant step towards enhancing healthcare access and protection for individuals across all age groups in India.